Drug interactions
Ibrutinib + Warfarin
Severity: Major
Ibrutinib and Warfarin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ibrutinib impairs platelet function and adds to warfarin's anticoagulant effect, increasing the risk of serious bleeding. Patients with thrombocytopenia or other bleeding risk factors are at higher risk.
What this interaction means in plain words
Ibrutinib and Warfarin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ibrutinib belongs to Oncology; Warfarin belongs to Cardiovascular.
Why it happens
Ibrutinib inhibits Bruton's tyrosine kinase and related kinases involved in platelet activation, producing additive pharmacodynamic bleeding risk.
What to do
Avoid the combination if possible, or use close INR and bleeding monitoring and consider an alternative anticoagulation strategy. Hold ibrutinib around surgery according to labeling.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Warfarin?
MediHelp rates the interaction as major. Ibrutinib and Warfarin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ibrutinib impairs platelet function and adds to warfarin's anticoagulant effect, increasing the risk of serious bleeding. Patients with thrombocytopenia or other bleeding risk factors are at higher risk.
How serious is the interaction between Ibrutinib and Warfarin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible, or use close INR and bleeding monitoring and consider an alternative anticoagulation strategy. Hold ibrutinib around surgery according to labeling.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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